Health Care Service Corporation

Analyst

• Support the Eligibility Department through technical tasks
• Load Triple E files
• Perform manual eligibility updates
• Enter and/or modify eligibility data in Luminare Health systems according to established procedures and client requirements
• Provide timely and accurate service
• Respond to telephone, written, and electronic inquiries from employees/members, clients, and co-workers

Technical Eligibility Analyst

Supervisor

• Supervise and manage the day-to-day operations of a team of Claim Analysts
• Enable the team to meet client and corporate commitments
• Achieve team quality, production and service expectations
• Develop staff
• Support successful implementation of new clients into the Unit
• Retain existing clients
• Answer complex or difficult claim questions
• Work collaboratively with the department manager to ensure department goals are met

Supervisor, Claims

Manager

• Supervise and monitor care management staff
• Assure clinical accuracy of web-based and non-web-based content
• Monitor revisions to national standards of care and reflect them in the care management program
• Develop and implement department workflow processes that produce positive membership outcomes and achieve targeted metrics
• Provide feedback on department processes and quality initiatives
• Recommend steps for improvement
• Interface with internal and external customers
• Serve as liaison between customers and the medical management department

Technical Eligibility Analyst

Supervisor, Claims

Unit Manager, Care Management